Cited by 769Obstructive Sleep Apnea ResearchNeuroscience of respiration and sleepDysphagia Assessment and Management

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Waking genioglossal electromyogram in sleep apnea patients versus normal controls (a neuromuscular compensatory mechanism).

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Mezzanotte, W S, Tangel, D J, White, D P·1992·Journal of Clinical Investigation

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Abstract

Pharyngeal collapse in obstructive sleep apnea patients is likely a product of a sleep-related decrement in pharyngeal dilator muscle activity superimposed upon abnormal airway anatomy. We postulate that during wakefulness, increased pharyngeal dilator muscle activity in apnea patients compensates for diminished airway size thus maintaining patency. We studied the waking genioglossus (GG) electromyogram (EMG) activity in 11 OSA patients and 14 age-matched controls to determine if GG activity is higher in the awake state in apnea patients than controls. To make this determination, we developed a reproducible methodology whereby true maximal GG EMG could be defined and thus basal activity quantitated as a percentage of this maximal value. Therefore, direct comparisons of basal activity between individuals was possible. We observed apnea patients to have significantly greater basal genioglossal activity compared to controls (40.6 +/- 5.6% vs. 12.7 +/- 1.7% of maximum). This difference persisted when size-matched subsets were compared. This augmented GG activity in apnea patients could be reduced with positive airway pressure. We speculate that this neuromuscular compensation present during wakefulness in apnea patients may be lost during sleep leading to airway collapse.

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Authors: Mezzanotte, W. S., Tangel, D. J., & White, D. P.
Affiliations: Denver VA Medical Center (US)
National Jewish Health (US)
Venue: Journal of Clinical Investigation
Publisher: American Society for Clinical Investigation
Published: 1992-05-01
Volume: 89
Issue: 5
Pages: 1571-1579
ISSN: 0021-9738 (ISSN-L)
DOI: 10.1172/jci115751
PMC: PMC443031
OpenAlex: W2139404323
Cited by: 769
References: 56
Citations by year: 2026: 18 · 2025: 9 · 2024: 25 · 2023: 23 · 2022: 18 · 2021: 14 · 2020: 23 · 2019: 32 · 2018: 33 · 2017: 23 · 2016: 21 · 2015: 30 · 2014: 44 · 2013: 22 · 2012: 26
FWCI: 4.11
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Journal of Clinical Investigation (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: National Heart, Lung, and Blood Institute (HL-07085, T32HL007085)
Topics: Health Sciences › Medicine › Physiology (medical) › Obstructive Sleep Apnea Research
Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Neuroscience of respiration and sleep
Health Sciences › Health Professions › Speech and Hearing › Dysphagia Assessment and Management
Keywords: obstructive sleep apnea, genioglossus muscle, pharyngeal dilator muscles, neuromuscular compensation, pharyngeal collapse, airway patency, positive airway pressure, wakefulness
MeSH terms: Electromyography, Humans, Male, Pharynx, Sleep Apnea Syndromes, Wakefulness

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Waking genioglossal electromyogram in sleep apnea patients versus normal controls (a neuromuscular compensatory mechanism).

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